<form action="" class="form-horizontal" id="coupon_edit">
    <table>
        <tr><td width="50%;">每个用户充值次数</td><td width="50%;"><input type="text" class="form-control"  placeholder="" name="account"></td></tr>
        <tr><td width="50%;">每个IP充值次数</td><td ><input type="password" class="form-control"  placeholder="" name="password"></td></tr>
    </table>
</form>